[Medical Human Story – Episode 71] The Last Breath Missed by AI: Systemic Sclerosis-1
Prologue: The Cyanotic Glass City
Stagnant Air
The air in the emergency room froze instantly.
It was 3:00 AM—the hour when the boundary between life and death wears thinnest, and human vulnerability is exposed raw. Beep—beep—beep—. The serene stillness of the ER was shattered under the piercing shriek of the vital monitor. Urgent footsteps scraped across the corridor, and the frantic shouts of the medical staff tore through the stagnant air.
"Oxygen saturation is at 78%! Respiratory depression is progressing rapidly! She’s going into cardiac arrest at this rate! Prepare for intubation, now! Hurry!"
Lying on the gurney was 43-year-old Seo-yeon Lee. Her entire body had turned cyanotic—a ghostly shade of blue. Gasping for air that refused to fill her lungs, she groaned in the throes of severe hypoxia. Her chest heaved violently as if each breath might be her last. The physician on duty rushed over, scrambling to secure her airway.
Yet, the moment his hands touched her body, the doctor froze, struck by a chilling sense of aberration.
Her anatomy felt uncanny.
Her fingertips, turned a deathly blue from the lack of oxygen, were more than just bloodless—they were hard, rigid, like cold pieces of stone.
Moreover, under the harsh glare of the surgical lights, her skin appeared abnormally smooth and thinned.
It no longer felt like human flesh; instead, it gleamed like translucent glass, appearing as though it might shatter into sharp, perilous shards at any moment.
A body stripped of human warmth.
Within it
coexisted a bizarre beauty reminiscent of a finely chiseled marble statue and
an unsettling, visceral horror that no living human should ever possess.
A Cold Warning Beyond the Monitor
At that exact moment, inside the reading room.
Enveloped by darkness, Kim Do-hyun, a second-year radiology resident, was rubbing his fatigue-laden eyes.
Right then, a sinister crimson alert flashed across the massive PACS (Picture Archiving and Communication System) monitor before him. Simultaneously, a sharp, ear-splitting alarm shattered the silence of the room.[AI ALERT: POSSIBLE INTERSTITIAL LUNG DISEASE – HIGH PROBABILITY]
It was a cold, mechanical diagnosis.
Long before a human physician could sift through the mountain of images to locate the root cause, the AI had analyzed the chest CT scan and spat out the verdict in a matter of microseconds.
Do-hyun swallowed hard, his throat dry.
The crimson glow reflecting off the screen cast a macabre hue over his face.
His fingertips trembled slightly as he zoomed in on the image.
"The AI
caught it first... But is it already too late?"
With a hesitant gaze, Do-hyun scrolled down through the patient’s chest CT data.
On the screen, Seo-yeon’s lungs were dying—filled not with the dark voids of life-sustaining oxygen, but with dense, white masses of fibrotic tissue.
A typical pulmonary disease would present as a hazy, mist-like formation, resembling white frost settling on tree branches—a phenomenon known as ground-glass opacity.
But Seo-yeon’s lungs were fundamentally different.
They looked like chunks of gray cement, completely calcified and solid, having aggressively crowded out every living cell.
An immense despair that, once hardened, could never be undone was already callously claiming the inside of her chest.
Just as a city
might slowly turn pale under an enigmatic blue twilight, her airway was
gradually petrifying into glass.
[Medical Insight] PACS and AI Diagnostic
Systems
Part I: The Silent Fissures of a Solidifying Life
The Betrayal of Ordinary Days
A mere six months ago, Seo-yeon Lee’s life was dazzlingly ordinary and therefore, infinitely warm.
Every morning at 6:30 AM, her alarm would faithfully ring, and she would head to the kitchen, rubbing the sleep from her eyes.
Ironing her husband's shirt as he prepared for work amidst the rich aroma of bubbling soybean paste stew, and helping her two children get ready for school as they whined sleepily—that was her universe, the sum total of her days.
In the afternoons, like any other mother, she would stop by the supermarket to pick up groceries for dinner, pushing her cart and exchanging casual pleasantries with neighbors. It was a perfectly mundane routine.
The fractures in that seemingly concrete reality began within a tiny, inconspicuous crevice. One morning, as autumn gave way to winter, a glass cup slipped from Seo-yeon’s hand while she was washing dishes, shattering loudly against the kitchen sink.
"Oh dear, where is my mind these days...?"
Believing it to be nothing more than a momentary lapse of strength, she swept up the broken shards. Yet, it began happening several times a week.
Whenever she
tried to button her children’s clothes, her fingertips would stiffen, refusing
to move as intended. As her knuckles swelled and a dull, throbbing ache set in,
she would simply shake her hands out and laugh it off to her husband.
"Honey, I think my hands keep stiffening lately because of the cold weather. I must have spent too much time on the computer."
"It’s fatigue," he replied. "You haven't been able to rest properly between running the kids to academies and managing the house. Don't do a single thing this weekend; just rest."
As her husband
said, Seo-yeon desperately wanted to believe it was just a mild accumulation of
fatigue.
She ignored the silent screams of her body, telling herself that with a little rest or some vitamins, she would be fine.
As is often the case with those who bear the title of "mother" anywhere in the world, her children’s snacks, the mountains of laundry, and the homework due tomorrow always took precedence over her own pain.
Her own suffering was a condition that could always be deferred—consistently relegated to the absolute periphery of her existence.
But time showed her no mercy.
Six months later, she found herself standing not in her warm kitchen, but outside a university hospital’s intensive care unit.
On a cold corridor bench that reeked of disinfectants, her husband sat staring blankly at the floor, the color completely drained from his face. His rims were bloodshot, yet his tears had long dried up, and his rough hands trembled violently with guilt.
As Do-hyun, the attending physician, approached from down the hall, the husband sprang up and clutched the fabric of the doctor's white coat.
"Doctor... I was a fool. I should have dragged her to the hospital by force. I should have known when her hands started changing like that... I killed my wife. I should have come sooner..."
Faced with the husband's agonizing wails of blood-drenched regret and self-reproach, Do-hyun could not summon a single word of consolation.
Even the hollow lie of "It’s a relief you brought her now" died in his throat.
For Do-hyun, as
her primary physician, knew all too well: this disease ravaging Seo-yeon was
not something that could be easily halted simply by early detection, nor was it
of a nature that could be wiped clean with a course of medication like a common
cold.
The Internal Petrification
What had brought Seo-yeon to her knees was neither a vicious flu nor mere chronic fatigue.
It was a shadowy, rare, incurable disease whose exact pathogenesis and definitive cure remain elusive even to modern medicine: Systemic Sclerosis.
This disease ravages the human body in the most cruel manner imaginable.
The tragedy begins when the immune system, which is supposed to defend against external adversaries, suffers an unknown malfunction and turns its fury inward, ruthlessly attacking its own body.
In response to the onslaught of immune cells, the body sends faulty signals to heal the perceived wounds.
Consequently, it triggers an abnormal overproduction and accumulation of collagen—the primary component of connective tissue.
This excess collagen drives a process of "fibrosis," transforming pliable skin and internal organs into rigid, scar-like tissue.
Quietly, yet without a single moment of reprieve, it strangles a person from within, serving as a sadistic life sentence that slowly petrifies a living human into stone.
When Do-hyun went on his rounds and examined Seo-yeon’s fingertips, they no longer felt like normal human flesh.
The natural wrinkles over her knuckles had vanished without a trace; her skin was stretched so taut that it felt as rigid as a doll's hand.
Illuminated by the clinical lights, the back of her hand gleamed unnaturally, resembling finely polished marble or hardened glass.
It was the grim reality of cells unable to breathe, locked in petrification.
Yet, the hardening of her skin was merely the opening act.
The true horror was unfolding where the eye could not see.
That fatal petrification process—which had frozen Seo-yeon’s fingers and embalmed her outer surface into a smooth shell—was now infiltrating deep inside her chest.
It was invading her lungs, the very organs that must remain soft and elastic to sustain human life.
As the alveoli, which are meant to expand and contract flexibly like balloons, hardened, Seo-yeon was forced to endure an agony akin to swallowing dry sand with every single breath.
The terror of a body transforming into a fossil from the inside out was completely devouring her life.
[Medical Insight] Systemic Sclerosis
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The above content is a web novel created by adapting the blog post
"https://leesangbock.blogspot.com/2026/06/systemic-sclerosis-imaging-ai-diagnosis-case-study.html". |
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